Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | OTA11231 | FL |
NPI | 1508244542 |
---|---|
Provider Name | Mr. Sean Youmans |
First Address | Tampa, FL 33609-1983 |
Second Address | Tampa, FL 33609-1983 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2015 |
Last Update Date | 11/05/2015 |